Healthcare Provider Details

I. General information

NPI: 1700437498
Provider Name (Legal Business Name): LINDA DEL AGUILA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2019
Last Update Date: 07/28/2021
Certification Date: 07/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1785 E SAHARA AVE STE 160
LAS VEGAS NV
89104-3759
US

IV. Provider business mailing address

1785 E SAHARA AVE STE 160
LAS VEGAS NV
89104-3759
US

V. Phone/Fax

Practice location:
  • Phone: 714-780-0750
  • Fax: 714-780-0757
Mailing address:
  • Phone: 702-252-8342
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberM14016
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: